Medicare pays for a lot of medical and hospital costs for folks who are 65 and older and also for younger folks with disabilities. If Medicare went away, lots of people might not have enough money for regular health care. It can be expensive and worrying if one doesn’t know all about their health care coverage. Here are some important things to know so that a person can pick the right Medicare plan.
Traditional Medicare Coverage
Medicare Part A covers some costs for hospital stays, skilled nursing care, hospice, and home health services. It usually doesn’t cost anything if a person has paid Medicare taxes while working.
Medicare Part B is for doctor visits, mental health care, medical equipment (like walkers), preventive services (including COVID-19 vaccines), and outpatient care. Unlike Part A, Part B’s cost depends on one’s yearly income; higher earners pay more.
Medicare Part D offers prescription drugs for an extra monthly fee. All Part D plans cover certain drugs (like those for cancer or HIV/AIDS), but each plan has its own list, and prices can differ.
When people choose original Medicare, they might also get Medigap (supplemental insurance) if their former employer or union doesn’t provide it. Medigap, sold separately for a monthly fee, helps with costs like copayments, coinsurance, and deductibles for those on original Medicare.
Which Preventive Services Does Medicare Part B Cover?
Thanks to the Affordable Care Act, Part B health coverage offers various preventive health benefits without charging a person. These include:
Yearly wellness visit.
Screenings for cardiovascular disease.
Screenings for colorectal cancer.
Screenings for diabetes.
Specific vaccinations.
However, it’s important to read the details carefully. For instance, while Part B covers many preventive services at minimal or no cost, it covers wellness visits but not yearly physical exams.
What Is a Medicare Advantage Plan?
Some folks choose to join a Medicare Advantage plan offered by a private insurance company instead of going for original Medicare. While Advantage plans have lower premiums than original Medicare, especially if one has a separate Medigap plan with its own monthly premium, the network of doctors and specialists in a Medicare Advantage plan is usually more limited. A person might need permission before seeing a specialist or getting certain treatments. Unlike original Medicare, where someone can buy separate drug coverage, Medicare Advantage plans include prescription coverage.
Medicare Advantage plans cover prescription drugs, and some even provide money for over-the-counter drugs. They often cover services not included in regular Medicare, like eye care, hearing care, and dental services. Some plans might also pay for things like transportation to medical visits or meal delivery, even if they’re not strictly medical services.